1. Pharmaceuticals from Households: A Return Mechanism

2. Who is PH:ARM ? Snohomish County Solid Waste Management Division Local Hazardous Waste Management Program in King County Public Health / Seattle & King County Northwest Product Stewardship Council Washington Citizens for Resource Conservation Pacific Northwest Pollution Prevention Resource Center Washington State Department of Ecology Washington State Department of Social and Health Services Washington State Board of Pharmacy Group Health Cooperative Bartell Drugs (Interest from many others, including pharmacies)

3. 3 Basic Tenets for Success Safe and secure system (secure collection, transport, destruction) Low-cost and financially sustainable Effective (high volume recovered) –Easily accessible & user friendly –Ongoing and widely available Government regulates and oversees the on- going program but does not fund and manage it. This should be left to the private sector.

4. 4 Meeting the Public’s Needs It should be as easy to properly dispose of medications as it is to purchase them. Public comfort with solution is key to success. January 2006 SoundStats Survey showed that: 74% of respondents said that they would be willing or very willing to properly dispose of unwanted medicines if a convenient location is offered. 84% of respondents indicated a local pharmacy would be the most convenient location to dispose of unused or expired medicines. 4% said they would be willing to use sheriff or police office, 5% said special collection event, 2% said public hazardous waste facility. Source: SoundStats Survey of King County Households (2006, WCRC)

5. British Columbia Pharmaceutical Take Back Over 850 Retail Pharmacies Voluntarily Participate

6. 5 MRW Facilities = 54 locations

7. Pharmacy Locations = 1,300 locations

8. The Take it Back Network

10. 10 PH:ARM Pilot and Transition Program Began November 2006. Initially launched with 7 Group Health locations. Expanded to 24. Initial launch at several Bartell Drug Pharmacies in 2008. Could expand to 54. Address adult care and others locations later in 2008. Pilot to run for 2 years then transition from government and NGO grant funding. Work toward state-wide product stewardship system. Work to resolve DEA and other reg issues.

11. First Prototype: Metal Drop Box 11

12. 12 PH:ARM Pilot: Destruction Group Health Clinic: Renton 12

13. Secure Effective Take-back 29 Collection Sites > 10,000 pounds

14. 14 Double Locked Container Can Only be Opened with Two People

15. 15 Bucket Closed with Lock Lid Under Double Witness

16. 16 Each Bucket Has Unique Tracking Number and Security Tag

17. 17 Each Bucket Is Carefully Tracked

18. 18 Buckets are Returned to Pharmacy Distribution Center, Recorded, and Placed in Locked Cage

19. 19 When Enough Buckets Have Accumulated, They Will Be Picked-up For Secure, Witnessed Destruction

20. Media Coverage The Seattle Post-Intelligencer: “Curing the Problem of Discarding Pills” 2/1/2007 The Herald: “Soon less trash may go into landfill” 2/6/2007 The Washington Post: “New Tricks for old drugs” 3/13/2007 USA Today: “Close the Lid On Old Medicine” 4/22/2007 The Spokesman review: “Pharmacy Disposal Sites established” 4/22/2007 King TV: “Drug Take Back Program Protects Streams and Fish” 3/2/2007 KHQ TV: “Flushing Old Medicines is No Longer the Most Sound Advice” 3/2/2007 Northwest Cable News: “Drug Take Back Program Protects Streams and Fish” 3/2/2007 KOMO AM 1000: “Flushing Old Medicines Not the Best Option” 3/2/2007 KUOW: “Group Health Creates Pilot Program for Disposing Old Medication” 3/5/2007 Green Daily: “Get these Prescription Drugs to the Incinerator!” 1/28/2008 DiseaseProof.com: “Old Drugs, Where to Stick Them” 1/23/2008 Metroblogging Seattle: “Safely Dispose of Those Old Prescriptions” 1/22/2008

21. Growing and Irrepressible Demand

22. Compliance is High – 97%

23. Data Collection

24. 24 Group Health Decal

25. 25 Bartell and Group Health Fliers

26. 26 Bartell Drugs Flier and Poster

27. 27

28. For more information www.medicinereturn.com info@medicinereturn.com Sego Jackson – Snohomish County Sego.Jackson@co.snohomish.wa.us